Imagine you need to see a doctor, or health provider of some description…..what are the first thoughts, or feelings that come to mind and body? Is it “ah ok, well I’ll make that appointment, hope I don’t have to wait to long….” Or is it more feelings of dread, fear and avoidance? Chances are, if you relate to the former, you’re either part of the human race who enjoys privilege (usually smaller bodied, white/anglo, able-bodied, cis-gender) or have had overall positive experiences with providers in the health system. If this is the case, consider yourself fortunate. And most definitely in the minority. The fact is, for many people, seeking medical or health care is a highly fraught and stressful experience based on real, valid, lived experiences of being treated poorly in our health system. We also need to acknowledge that there is so much weight-based stigma in our culture that when a smaller-bodied provider talks about weight to a larger-bodied person that this in and of itself can create feelings of shame, guilt and defensiveness. The very feelings that stop people from getting the care they need.
This needs to change. Urgently. It’s not good enough that people are going in for a rash, and leaving with a diet. Seeking help for a throat infection, leaving feeling coerced into being weighed. And, most importantly, without proper care. Until the time comes when health provider training includes a direct and broad examination of bias and stigma, it’s time to take this shit into our own hands and find space for advocacy and using our own voices to demand the care that we all need, and deserve. I want to be clear that
1. You shouldn’t even have to do this
2. You are under no obligation to do so
3. You may need support in doing so.
How you deal with your own experiences in our health care system is 100%, totally up to you. But it’s very important to remember that even though this may have become an issue for you, it’s not your fault. But if you do want to use your voice, we’ve got some ideas, because you are in a good position to make a difference. Often, providers are unaware of their own language, attitudes and reactions. They have grown up in this culture too where assumptions are made about certain bodies. This doesn’t make it right – it’s not – but until they are exposed to learning opportunities, they too will keep doing what they’ve been doing.
So….what can I say?
To get you started, we’ve come up with 12 things you could say if you’re finding yourself in a situation where your health provider is offering you “advice” which feels counter to your experience or what you know is most helpful for you. Or you simply want more information (which you have every right to ask for!) You don’t need to be an academic to do this – most often, weight-based advice is not evidence-based or coming from a thorough understanding of risks or you as a unique person rather than “n” in a study (no one is an “n”!!)
We don’t know exactly what will help in every situation, and we can only do as much as we have the energy for. Again, I repeat – you are under no obligation to do, or say anything – we get that these conversations can be deeply uncomfortable. But first and foremost, please keep in mind that you (and everyone!) deserves compassionate and respectful care for whatever it is you’re looking to take care of. Full stop.
I know we’ve only got a short time, so I’d really like to focus on what I came here for please.
I’d like to work in a weigh neutral way if that is possible as weight loss efforts have only resulted in weight gain for me (this is also supported by the evidence, which I am happy to provide)
What would you be recommending to me if I had a smaller body? Could we start there?
I have a history of dieting/weight cycling/disordered eating/eating disorder. I’ve tried (what you’re suggesting) before, & it made things worse for me. Do you have another suggestion for me, perhaps one you would give to someone in a smaller body?
Is there any research about health outcomes or sustained success with the amount of weight you’re suggesting that I need to lose? Do people lose that amount of weight, and keep it off long term?
(When referring for WLS) I understand that there can be significant risks with weight loss surgery, including death and severe complications. Can you tell me more about that please?
What does the research say about (X/Y/Z intervention/treatment)? Are there long term studies, 3 years or more?
I have a history of an eating disorder and I’ve been advised that weight loss dieting and/or cutting out food groups is a risk factor for relapse.
(Insert nutrition recommendation) sounds like a diet to me and I’ve done that a lot in my life. It’s not good for me, and I don’t want to diet anymore. Can you refer me to a Non-Diet or Weight Neutral Dietitian who understands my history and make recommendations?
Making me feel bad about my body is something people have been doing for years. Please don’t, it makes things worse for me and I’m less likely to come back to you, although I really need healthcare.
Rather than focussing on my weight, I’d rather focus on health behaviours. Can you refer me to a health care provider (eg Dietitian, Podiatrist, Physiotherapist, Exercise Physiologist, Occupational Therapist, Psychologist) who might be able to support me without focussing on my weight?
(In response to being asked to step on scales)
I’d rather not be weighed thankyou.
I’m OK for you to know, but I don’t want to know the numbers thankyou.